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December 2013 / January 2014

"Let us not look back in anger or forward in fear but around in awareness."

by James Thurber

Happy 2014 from all of us at The NeuroNova Centre!

In This Issue

“Majestic Winter”
The work of award-winning photographer Heather-Waller-Rivet has appeared in many magazines, exhibits, and diverse public and private collections. She was also recognized as one of 2009’s“Top Emerging Photographers in Canada” by Photo Life magazine.

Book Review:  Why Zebras Don’t Get Ulcers: The Acclaimed Guide to Stress, Stress-Related Diseases, and Coping


By Robert M. Sapolsky. (3rd ed.) New York, NY: Henry Holt & Co., 2004.

Reviewed by Dr. Jackie Gardner-Nix

Dr. Sapolsky is a Professor of Biology and Neurology at Stanford University, and has researched animal behaviour in Africa for many years. It is this leading-edge research that forms the basis of his book, which looks at how stress impacts humans and offers strategies to cope. Specifically, chapters deal with how stress affects memory, growth, the immune system, sleep, depression, aging, addiction, and many other mind/body systems. This book, therefore, is a great companion to our mindfulness courses because they share the same message.
 
Dr. Sapolsky sets out to explain that medicine now understands that every cell in our body is influenced by not just our lifestyle habits, but also by our personalities and emotions. Accordingly, we cannot know much about the disease or dysfunction afflicting an individual, unless we understand how that individual interacts with their environment — socially, emotionally, physically, and even spiritually.
 
Dr. Sapolsky manages to use humour to enliven what could otherwise be dry material. He amusingly describes how our body maintains its natural balance of hormones and chemicals. He defines the word “homeostasis”, which means constancy through change—like having a caretaker to ensure that when our systems are pulled too much in one direction, compensation occurs so that everything else is still adequately supported. For example, when we stand, instead of our blood pressure dropping into our boots, our brain detects the change so quickly that a hormone or two is secreted instantly to narrow the blood vessels serving our brain, thus avoiding dizziness. Some medications, and sleep deprivation, can interfere with that.
 
The human brain is so well developed compared with many other mammals that it even anticipates when a change may occur, so as to be even more ready to compensate. This may sound ideal, but it can end up lengthening the period of “standing by”, or stress, especially in anxious individuals. The chronic nature of this “on alert”, continually anxious and stressed state has many adverse outcomes on our bodies and minds. Interestingly, this is not seen as much in zebras. Also, when zebras are running from lions, their very activity is good for their systems. So, once out of range of the lion, they recover faster. Unfortunately, this is not the case for humans experiencing stress.
 
One size never fits all, so some individuals handle stress better than others—there are reasons for that—but there are some universal outcomes: the child denied loving handling tends to be growth-stunted; we will all age, but at different rates depending on our lifestyle choices, stress exposure, coping, and genetics; and, our immune system is suppressed by chronic stress exposure and also aging.
 
Although this book is intended for the general public, it can be a challenging read. Health care professionals who may be more comfortable with the material will find this to be a fabulous read. Regardless, this book can help show everyone ways in which we can soften the effects of these stressful challenges on our bodies and minds, in order to maintain an optimal quality of life. 

Expressing Pain Through Art


The following poem was written by a participant during the creative task part of our Mindfulness-Based Chronic Pain Management (MBCPM) course. It was requested to be placed in the Newsletter because it resonated with several other participants who heard it. It accurately captures the journey that many embark upon in doing the work of the MBCPM course. 
 

The Journey

 
You’ve been there for quite a while
I spent so much time ignoring you…
Going on with my daily life…
Working…at times struggling…
Yet pretending you didn’t exist.
And then your presence became more evident
I could no longer ignore you
You started to devour me…
Taking me a prisoner.
One day I was working
And the next I was home…
Terrified… Wondering what was happening…
There were moments when I could close my eyes
And visualize that you were gone…
And all was right in my world
And then… then you would consume me
All I could feel… all I could think of
Was you…
I fought you… wanted you out of my life…
At times I was so anxious I thought I’d be hospitalized…
That you were taking over my very existence.
I have gone from pillar to post…
Trying to find a solution…
I would fight this… I would win…
And each visit led to disappointment…
There was no magic cure.
What would happen to me???
From one there was reassurance that this
Was temporary…
From another… there was little they could do…
And the beat went on.
And in my moments of clarity
I realized that this is part of my journey…
That there are lessons to learn…
One of them being patience…
Another – one of the most important
To love my body…
To care for me…
Be gentle with me…
That the pain is a part of me…
Not to be ignored, to be treated with tenderness…
And if possible, not as an enemy, but a friend.
The Pain Management Course
Has helped me greatly on this path…
This Journey on the path called life.
Meditations at times have soothed me…
Have reached to my soul…
Bringing a feeling of peace.
At other times… the meditations have
Brought me to the depths of despair.
Yes… it is a journey of discovery…
Of hope… of recovery…
My life will never be the same
Yet for the most part…
The anxiety is less…
The pain is a part of me…
We’re learning to be on friendlier terms…
Possibly you could call it co-existence…
What will tomorrow bring???
Will this pain fade???
I only have this moment…And when I focus on the now
I feel a sense of serenity…
A feeling of hope…
And gratitude.
My friend and I
Are living in the moment…

By Marilyn G.
MBCPM Class Participant, November 2013

You Asked: 

 

Do Opioids, such as Morphine, Affect the Immune System?


Answer: There is some evidence in the research literature that opioids can reduce the effectiveness of the immune system, and we have seen some clinical evidence of infections being treated by antibiotics that do not heal until the opioid dose is lowered. The suspected reason is that the opioid drugs might occupy the opiate receptors that naturally appear on the surface of immune system cells, thereby preventing their occupation by natural internal opiates (endorphins), which appear to promote healing. There are likely other ways that the opioid drugs interfere with the natural endorphin effects on enhancing immunity, too. However, the stress of intense pain also decreases immune system function, so if your pain is well relieved by an opioid prescribed to you, it may be better for you to get some pain relief as it may in turn help your immune system.  

Source: Vallejo R, de Leon-Casasola O, Benyamin R. Opioid therapy and immunosuppression: a review. American Journal of Therapeutics. 2004; 11(5): 354-365. http://europepmc.org/abstract/MED/15356431

Did You Know That?


Bangor University in Wales, United Kingdom, has a large department devoted to Mindfulness—The Centre for Mindfulness Research and Practice (CMRP). Find out more at: http://www.bangor.ac.uk/mindfulness/

Future NeuroNova Centre Courses / Workshops


We are exploring new ways of offering the MBCPM course in 2014 to better meet your needs.
 

For Chronic Pain Sufferers

  1. The equivalent of the 13-week, MBCPM Level 1 Course will be offered cumulatively over three weekends for those who can access Toronto and who have challenges attending the courses on weekdays. The course is tentatively booked for the weekends of June 14/15 (Module 1: Equivalent to the first five classes); June 28/29 (Module 2: Equivalent to classes six–10); and, July 12/13 (Module 3: Equivalent to classes 11–13).  They will take place in the Li Ka Shing Education and Knowledge Institute, behind St. Michael’s Hospital. Saturday classes will run from 9:30am–4:30pm, and Sunday classes will run from 9:30am–1:00pm. Dr. Jackie Gardner-Nix will co-lead with another facilitator. (If you live outside of Toronto but would still like to take this course, you may wish to stay in the city for these Saturday nights in order to attend the classes.) 
  2. In August 2014, the equivalent of the 13-week, Level 1 MBCPM Course will be offered over four full days, from August 11–15 (one of these days will be a day off). Each day’s class will run from 9:30am–4:00pm. They will be held at the Li Ka Shing Education and Knowledge Institute, behind St. Michael’s Hospital. Dr. Jackie Gardner-Nix will co-lead with another facilitator 
  3. Emotional Skills: Alumni have long requested that this course be offered again. We are planning to do so starting in late April 2014, although the course will not run consecutive weeks. We will post the dates, times, and telemedicine sites for this course on the NeuroNova Centre (NNC) website as soon as we have confirmed site availability. 
  4. We would also appreciate your input as to whether you would like one-to-one teaching by phone from one of our trained facilitators in MBCPM, or to participate from your home in a “virtual” classroom through e-mindful. (These options are not covered by OHIP. Our staff can discuss costs with you.) 
 

For Health Care Professionals

  1. Dr. Jackie Gardner-Nix will do a one-day workshop on MBCPM at the Centre for Mindfulness Studies (CFMS), 180 Sudbury Street, Toronto, on Friday, March 21 from 9:30am–4:30pm. Any participant who then wishes to go on to MBCPM Facilitator Training will have the price of this workshop deducted from the cost of their training. 
  2. A Spring 2014 MBCPM course for health care professionals is planned, starting in late April, though it will not run consecutive weeks. We will post the dates, times, and telemedicine sites for this course on the NNC website as soon as we have confirmed site availability.
  3. We are pleased to report that the first MBCPM Facilitator Training Course for 2014 is full and already underway! The second course for 2014 is scheduled for the weekends of April 26/27 (Part 1, 9:30am–4:15pm on both days), and May 10 (Part 2, 9:30am–4:15pm). It will be held at the NNC offices.  
  4. An August Practicum and MBCPM Facilitator Training will take place in Toronto from August 11–20, 2014, where facilitators can experience the Level 1 Course with patients taking it in the four-day format, followed by curriculum training.

Topics for upcoming issues:

  • Book reviews
  • You asked:
  • Did you know that?
  • Medication can have side effects.  Can Mindfulness?
As always, we welcome your submissions! Please send any articles, book reviews, or contributions for the Newsletter to:  www.admin@neuronovacentre.com
All previous issues of our Newsletter are available at www.neuronovacentre.com/blog

Mindful Pain Solutions News is published by The NeuroNova Centre for Mindfulness-Based Chronic Pain Management
www.neuronovacentre.com
www.shopneuronova.com

Newsletter Staff
Dr. Jackie Gardner-Nix MB.BS., Ph.D., MRCP(UK), Editor-In-Chief
This Newsletter Edited by:  Camille Marajh 
ITRM Consulting Inc. Publisher
Copyright © 2014 NeuroNova Centre for Mindful Solutions Inc., All rights reserved.


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